Obama budget would cut pediatrician training at Children's Hospital

WASHINGTON -- A federal program that gives Children's Hospital in Birmingham about $5.5 million a year to train pediatricians would be terminated by President Barack Obama's 2012 budget.

Eliminating the graduate medical education program for children's hospitals nationally would save $318 million a year, according to Obama's spending outline released Monday morning.

If Congress doesn't restore the money, Children's likely would have to reduce the number of pediatricians it trains in residency programs. That would shrink the pipeline of pediatricians, who already are in short supply, especially in some key specialties.

The program is one of hundreds of cutbacks on the table as Congress considers federal spending priorities for the 2012 fiscal year, and it illustrates the coming battles as each proposed cut comes with a constituency that will fight to keep it alive.

The money for training pediatricians is one of about 200 federal programs targeted by Obama to trim $33 billion starting in 2012. The White House wants to cut the program in favor of competitive grants "that create incentives for improved performance," according to the president's budget.

Congress began the subsidy to about 60 children's hospitals 10 years ago to match the federal support that goes to teaching hospitals that serve Medicare patients. Advocates say the $1.4 billion allocated during that decade reversed a decline in the number of pediatricians in residency programs, but shortages persist and cause lengthy waits for appointments with pediatric specialists in neurology and surgery, for example.

"What our nation cannot afford is to further jeopardize children's access to physicians trained to meet children's unique health care needs," said Lawrence McAndrews, president and CEO of the National Association of Children's Hospitals.

The association reports that, in Alabama, there is one pediatric specialist in pulmonology and .8 in gastroenterology per 100,000 children.

"Any reduction to the program funds would require a significant program restructuring for us," said Tom Shufflebarger, chief operating officer of Children's Hospital in Birmingham.

He said Obama's budget is the first step in a long process and the hospital will work with the state's congressional delegation to find a solution. In partnership with the UAB School of Medicine's Department of Pediatrics, Children's trains about 70 percent of Alabama's pediatricians.

The University of South Alabama Children's Hospital receives about $2.6 million in graduate medical education funding every year, as well.

It was not clear whether Obama's proposal would survive in Congress, which has spared the pediatric training money in previous budget cycles. Obama's budget includes $400 billion in reduced spending over five years, but Republicans are clamoring for more.

Rep. Terri Sewell, D-Birmingham, said in a prepared statement that, while she agreed Congress will have to make tough budget decisions, she wanted to look more closely at cuts that would affect her 7th Congressional District, particularly the cut to pediatric training.

"It is disconcerting that this proposed cut would cause Children's Hospital in Birmingham to lose significant funding and could lessen the number of physicians that provide care to our children, and I plan to look at this proposal very carefully," Sewell said. "Constituents need to continue to have access to the vital health care services that they need, and funding for programs that create jobs should continue to be supported." Republican plan At the same time as the 2012 debate heats up, Republicans in the U.S. House are pressing for $100 billion in cuts for the remainder of the 2011 fiscal year. Notably, the House GOP cuts would leave the pediatric graduate medical education money intact, according to a list provided by the House Appropriations Committee.

U.S. Rep. Spencer Bachus, R-Vestavia Hills, said he was focused on this week's votes to cut 2011 spending and has yet to review the details of the 2012 proposal.

Also Monday, Sen. Jeff Sessions, ranking Republican on the Senate Budget Committee, helped lead the GOP criticism of Obama's overall proposed budget, appearing with House Budget Committee Chairman Paul Ryan of Wisconsin at a Capitol Hill news conference. They said Obama's proposal doesn't cut enough spending, doesn't go far enough to reduce the federal debt, wrongly includes tax increases and doesn't include changes to make Social Security and Medicare solvent.

"If we follow this course it will be a national tragedy," Sessions said.